Jeong Yeonsong, Kim Min-A
Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2023 Jul;66(4):270-289. doi: 10.5468/ogs.22323. Epub 2023 May 17.
The coronavirus disease 2019 (COVID-19) outbreak which started in December 2019 rapidly developed into a global health concern. Pregnant women are susceptible to respiratory infections and can experience adverse outcomes. This systematic review and meta-analysis compared pregnancy outcomes according to COVID-19 disease status. The MEDLINE, EMBASE, and Cochrane Library databases were searched for relevant articles published between December 1, 2019, and October 19, 2022. Main inclusion criterion was any population-based, cross-sectional, cohort, or case-control study that assessed pregnancy outcomes in women with or without laboratory-confirmed COVID-19. Sixty-nine studies including 1,606,543 pregnant women (39,716 [2.4%] diagnosed with COVID-19) were retrieved. COVID-19-infected pregnant women had a higher risk of preterm birth (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.42-1.78), preeclampsia (OR, 1.41; 95% CI, 1.30-1.53), low birth weight (OR, 1.52; 95% CI, 1.30-1.79), cesarean delivery (OR, 1.20; 95% CI, 1.10-1.30), stillbirth (OR, 1.71; 95% CI, 1.39-2.10), fetal distress (OR, 2.49; 95% CI, 1.54-4.03), neonatal intensive care unit admission (OR, 2.33; 95% CI, 1.72-3.16), perinatal mortality (OR, 1.96; 95% CI, 1.15-3.34), and maternal mortality (OR, 6.15; 95% CI, 3.74-10.10). There were no significant differences in total miscarriage, preterm premature rupture of membranes, postpartum hemorrhage, cholestasis, or chorioamnionitis according to infection. This review demonstrates that COVID-19 infection during pregnancy can lead to adverse pregnancy outcomes. This information could aid researchers and clinicians in preparing for another pandemic caused by newly discovered respiratory viruses. The findings of this study may assist with evidence-based counseling and help clinicians manage pregnant women with COVID-19.
2019年12月开始的2019冠状病毒病（COVID-19）疫情迅速发展成为一个全球卫生问题。孕妇易患呼吸道感染并可能出现不良后果。本系统评价和荟萃分析根据COVID-19疾病状态比较了妊娠结局。检索了MEDLINE、EMBASE和Cochrane图书馆数据库中2019年12月1日至2022年10月19日发表的相关文章。主要纳入标准是任何基于人群的横断面、队列或病例对照研究，这些研究评估了实验室确诊或未确诊COVID-19的女性的妊娠结局。检索到69项研究，包括1,606,543名孕妇（39,716名[2.4%]被诊断为COVID-19）。感染COVID-19的孕妇发生早产（优势比[OR]，1.59；95%置信区间[CI]，1.42-1.78）、子痫前期（OR，1.41；95%CI，1.30-1.53）、低出生体重（OR，1.52；95%CI，1.30-1.79）、剖宫产（OR，1.20；95%CI，1.10-1.30）、死产（OR，1.71；95%CI，1.39-2.10）、胎儿窘迫（OR，2.49；95%CI，1.54-4.03）、新生儿重症监护病房入院（OR，2.33；95%CI，1.72-3.16）、围产期死亡率（OR，1.96；95%CI，1.15-3.34）和孕产妇死亡率（OR，6.15；95%CI，3.74-10.10）的风险更高。根据感染情况，在总流产、胎膜早破、产后出血、胆汁淤积或绒毛膜羊膜炎方面没有显著差异。本综述表明，孕期感染COVID-19可导致不良妊娠结局。这些信息可以帮助研究人员和临床医生为新发现的呼吸道病毒引发的另一场大流行做好准备。本研究结果可能有助于进行循证咨询，并帮助临床医生管理感染COVID-19的孕妇。
